Question 1

When should ibuprofen NOT be given to a crew member at sea?

Accepted Answer

Contraindications: known allergy (including aspirin-induced asthma); active or recent peptic ulcer; kidney impairment; dehydration (NSAIDs reduce kidney blood flow); bleeding disorders; pregnancy (especially third trimester); concomitant anticoagulant use (e.g. warfarin) Ibuprofen (an NSAID) has important contraindications relevant at sea: dehydrated crew are at risk of acute kidney injury from NSAID use (NSAIDs reduce renal prostaglandins); asthmatic crew with aspirin sensitivity may bronchospasm; ulcer history risks GI bleed; anticoagulant users risk major bleeding. Before offshore passages, know crew medical history and which medications are contraindicated. Paracetamol has fewer contraindications and is a safer first-line choice in uncertain situations.

Question 2

A crew member recovered from cold water is shivering violently, confused, and pale. What stage of hypothermia is this and what is the correct treatment?

Accepted Answer

Mild to moderate hypothermia (core temp ~32–35°C) — remove wet clothing, insulate from wind and cold, warm with blankets and foil, give warm sweet drinks if conscious and no injury suspected, handle gently and do NOT rub limbs Shivering with confusion = mild-moderate hypothermia. Treatment: protect from environment; remove wet clothing (avoid vigorous movement — cold blood from extremities flushing to core can cause cardiac arrest); insulate; warm externally; do NOT rub limbs; give warm fluids only if conscious and uninjured. Severe hypothermia (rigid, no shivering) — treat as cardiac arrest, CPR may be needed.

Question 3

A near-drowning casualty has been recovered from the water. They are unconscious and not breathing. What is the immediate priority?

Accepted Answer

Start rescue breaths (5 initial breaths) immediately, then begin standard CPR (30 compressions : 2 breaths) — airway and breathing take priority as drowning is a hypoxic event Drowning is a hypoxic (oxygen deprivation) emergency. Unlike cardiac arrest in adults, rescue breaths are critical — give 5 initial rescue breaths, then 30:2 CPR. Continue until breathing resumes or help arrives. If on a vessel with no AED, focus on quality CPR with rescue breaths. Do NOT attempt to drain water from the lungs — it delays oxygenation and is ineffective.